EFFECT OF PROBIOTICS LACTOBACILLUS REUTERI IN THE AMELIORATION OF CANCER THERAPY INDUCED ORAL MUCOSITIS

Abstract

Oral mucositis (OM) affects approximately 40% of patients receiving standard chemotherapy, and 100% of those undergoing myeloablative chemotherapy, and head and neck radiotherapy. Severe OM is associated with poor quality of life, need for parenteral nutrition and intravenous analgesics, and prolonged hospitalizations. OM therapeutics remains largely symptomatic and has not improved significantly due to lack of advancement in the understanding of the pathophysiology of OM. Pre-clinical OM studies have shown a higher abundance of microbiota in ulcerated oral epithelium. Furthermore, the peak of bacterial colonization coincides with greater OM severity. Clinical studies have also reported that a shift of commensal flora from a largely gram positive to a gram negative bacteria occur during cancer therapy. However, the significance of oral flora in cancer therapy-induced OM pathophysiology remains poorly understood. In this study, we provide evidence that commensal oral flora impacts the severity of chemotherapy-induced OM. We further provided in vivo and clinical study data on the efficacy of the probiotic strain Lactobacillus reuteri in the amelioration of cancer therapy induced OM.